Let me paint you a picture. Every Monday morning, dental practices over the world power up for a week’s worth of drilling and filling, tooth removal, and reconstruction work. Queues of fearful patients, tearful children being comforted by anxious parents, people in considerable pain, line up outside the doors to their dental surgeries. Once inside, these patients are subjected to the traditional smells of oil of cloves, disinfectants, and the noises of the high pitch whine of the dental drill. To add to this picture, the odd scream or two filters through the hushed, usually silent waiting room into the street outside. It is a sad fact of life that every dentist is trained that if there is an area of decay in your tooth, the only way to treat this is to drill the decay out or amputate it, and then place a filling; at worse, the tooth may have to be removed.

Queues of fearful patients, tearful children are lined up outside the doors to their dental surgeries. These patients are subjected the smell of oil of cloves, disinfectants, and the whine of the dental drill; the odd scream or two filters through the hushed, usually silent waiting room

For a small minority of patients, where their dental practices have chosen to invest in modern technology, the opposite happens almost every day. The queue is one of bright, cheerful adults and children; there are few smells to associate this practice with the traditional one down the road. The noise of the drill is seldom heard, and happy smiling faces emerge from the treatment room.

Over the last few years, a number of researchers, lead by Professor Edward Lynch from Queen’s Dental Hospital and Belfast University, have opened a radically and revolutionary way forward. The dental profession no longer has to destroy tooth tissue to eliminate bacteria. A simple 60 second (average treatment time) treatment with a new dental device that delivers a burst of ozone will destroy all the bacteria that caused the infection and the decay. It destroys all the organic effluents that are produced by these bacteria, and by effectively sterilising the lesion, allows minerals from the patients own saliva to re-enter the areas of mineral loss to harden it. Once hardened, it is more resistant to future bacterial attack and mineral loss.

There is in all our mouths a natural balance. Your tooth surface losses minerals into your saliva at certain times, usually just after you start to eat. These acidic conditions favour mineral loss. As your saliva flow increases as you eat, your mouth becomes more neutral, and these conditions favour mineral uptake by your tooth surface. This balance can be upset by a number of different factors, but the most important is bacteria that normally live with us all.

When bacteria attach themselves to your tooth surface, they set up a complex community of some 450 different bacterial types over a period of time. If you try to skimp on using your tooth brush, or forget to use dental floss on a regular basis, these communities of bacteria evolve into one which produces large volumes of acids. These acids attack the tooth surface, dissolving out the minerals, leaving in about 5-6 weeks, a hole or cavity. As this cavity now gives the bacterial colonies a degree of protection, tooth brushing cannot remove the bacteria and so the process of decay accelerates.

Yet decay is only an infection process that leads to the softening of the tooth, and the formation of a cavity, so could this infection be treated with, say, antibiotics? The bacteria that cause tooth decay are often found deep within the structure of the tooth, so their removal has to date only been by amputating the infected part of the tooth. Antibiotics and other pharmaceutical agents cannot penetrate deep enough through tooth structure to eliminate these bacteria. This teaching and technique is based on sound engineering principles that originate from the Victorians! Despite modern advances, there is no simple test that can be applied to a cavity to tell the dentist if they have removed all the infection! And if areas of infection are left behind, there is a good chance that the filling placed will fail at some time in the future.

In an attempt to prevent further infection and to restore the tooth to its original shape and function, a filling is then placed. Studies over the years have shown that fillings do not last very long, any where from 6 months to several years. But once a tooth has had part of it amputated, there is no going back. For each time the filling needs to be removed and replaced, there is a little less of your original tooth left and a larger filling. A point is reached where there is no option but to opt for expensive reconstruction work with advanced dental care or have the tooth removed.

The dental professions goal is to help and educate you; it is not to cause harm or damage you

The dental professions goal is to help and educate you, the patient, how to avoid entering into this cycle of tissue amputation and periodic filling replacement. Oral care education and modern toothpastes have helped reduce the number of cavities, but in poorer communities, those with disabilities and in long term institutions, as well as our aging population, decay is still prevalent. And diet advice is often lacking, so although you may think you are doing well at home, the process of decay continues!

Teeth have a distinct cycle of mineral loss and uptake in your mouth. In the same way that your lungs allow your body to take in oxygen, and release carbon dioxide into the air, so your teeth have a similar cycle. Minerals, such as calcium and phosphate, are important building blocks that make up the hard structure of your teeth. By adding in certain other elements, such as fluoride, research has shown your teeth can be made more resistant to mineral loss.

Dental Ozone is a completely new way to look at decay. In the early stages of mineral loss, no use of the drill is required. The treatment is simple, inexpensive (certainly less than the cost of a filling), and requires no injection of anaesthetics. This does of course depend on the use of modern diagnostic equipment, such as the DIAGNOdent (KaVo GmbH). This laser is more accurate than x-rays, and far superior to the traditional mirror and probe that dentist often use. The mirror and probe are tools that can find holes, not diagnose areas of first stage decay. And research has shown that x-rays are very poor to visualise decay in a tooth surface, until it is 2-3 mm inside the inner layer of the tooth.

If the area of decay is deeper, and more extensive, Ozone still has a role to play. The dental drill may need to be used to remove the cover of enamel over the decay, but this can also be carried out with air abrasion. No local anaesthetics are required, and Ozone is used to sterilise the area of decay, without he need to amputate a large volume of tooth structure. In this way, damage to the tooth is limited, and the inherent strength is preserved as much as possible. Even in really deep areas of decay, Ozone can be used to preserve tooth tissue.

When Ozone is combined with traditional care, then there are a number of advantages that patients and the dental profession can make use of. The Ozone can be used to sterilise a cavity before a filling is placed, so there will be virtually no sensitivity after the local anaesthetic wears away. It can be used to eliminate sensitivity after new crowns or veneers are placed. And where wear facets have produced sensitive areas at the necks of teeth, in most cases a simple 40 second application with ozone can eliminate this sensitivity for 3-4 years. It may be for longer, but this treatment has only been available for 4 years! There are many more applications for Ozone in a general dental or medical practice, and the studies for some of these can be found on www.the-o-zone.cc. This www site not only allows you to find a dental practice which has and uses Ozone, but also allows you to view the research papers that have been published from centres around the world.

Monday morning at an ozone dental practice is not stressful; the waiting people is full of smiles, people chatting to the dental team members as they wait with happy anticipation

So perhaps a Monday morning at a dental practice that has invested in modern technology and has been properly trained, is no longer the stressful, painful and anxious visit that it used to be. The waiting people in this practice is full of smiles, people chatting to the dental team members as they wait with happy anticipation at being called through for their turn in the treatment room. Mums and dads with children have no fear or anxiety, as they are reassured that modern technology has opened a door for them, that most of the older population had never believed possible. For both the patient and the dental practice, it is a technology that has a winning solution for both; the treatment is fast, it is predictable, it is painless, and also reduces the long-term cost of the treated tooth. For the dental practice, the treatment times are reduced, it is profitable, and the treatment less stressful. For the patient, modern technology has allowed them to have a 21st century treatment, rather than one that is old fashioned, and out-dated.

Julian Holmes is a dental and medical author and researcher on ozone technologies. For many years he worked in the UK as a general dental practitioner, before retiring to South Africa to continue his research. Julian was one of the first innovators in the world to practice Ozone Dentistry, and has published a number of scientific research articles on this technology. He continues to lecture and present around the world, and can usually be found at www.the-o-zone.cc.